EP3359077B1 - Chirurgisches markerelement, chirurgische referenzierungseinheit und chirurgisches navigationssystem - Google Patents

Chirurgisches markerelement, chirurgische referenzierungseinheit und chirurgisches navigationssystem Download PDF

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Publication number
EP3359077B1
EP3359077B1 EP16781364.1A EP16781364A EP3359077B1 EP 3359077 B1 EP3359077 B1 EP 3359077B1 EP 16781364 A EP16781364 A EP 16781364A EP 3359077 B1 EP3359077 B1 EP 3359077B1
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EP
European Patent Office
Prior art keywords
marker element
accordance
marker
retroreflective elements
surgical
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP16781364.1A
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German (de)
English (en)
French (fr)
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EP3359077A1 (de
Inventor
Holger Broers
Andreas GÖGGELMANN
Tobias Pfeifer
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Aesculap AG
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Aesculap AG
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3937—Visible markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3983—Reference marker arrangements for use with image guided surgery

Definitions

  • the present invention relates to a marker element, in particular a medical or surgical marker element, for a referencing unit of a navigation system, which marker element is designed to reflect electromagnetic radiation, the marker element comprising a layer comprising a plurality of retroreflective elements and a carrier for the layer of retroreflective elements.
  • the present invention further relates to a referencing unit, in particular a medical or surgical referencing unit, whose position and/or orientation in space can be detected with a surgical navigation system, with at least one surgical marker element.
  • the present invention also relates to a navigation system, in particular a medical or surgical navigation system, with at least one referencing unit comprising at least three marker elements and with at least one detection device for detecting the position and/or the orientation of the referencing unit in space, the referencing unit comprising at least one surgical marker element .
  • Marker elements, referencing units and navigation systems in the form of surgical or medical marker elements, referencing units and navigation systems are, for example, from DE 10 2007 011 595 A1 known.
  • spheres are used as marker elements, which are covered with special films that reflect electromagnetic radiation, in particular infrared radiation.
  • the principle of triangulation is implemented with the navigation systems. Based on angle measurements and a scale, for example the orientation of two Detectors in the form of cameras calculate three-dimensional information from the referencing unit.
  • Features of the referencing unit are identified and assigned in the image data. It is also known, depending on requirements, to attach artificial signaling to the referencing unit and to measure it.
  • a particularly good relationship between features of the referencing unit to be measured and a background present in an operating room, for example, is achieved by self-illuminating marker elements, also referred to as so-called active marker elements.
  • a particular problem with the known passive marker elements that are coated with special films is that they only reflect diffusely, so that only a small part of the electromagnetic radiation emitted by the navigation system is ever sent back to it. This is particularly due to the fact that with a reflective surface, the radiation is only reflected back to the radiation source if it is aligned orthogonally.
  • a marker element of the type described above in that the carrier is formed from a carrier material that is transparent to electromagnetic radiation and that a outer surface of the marker element is formed by the carrier, that the material from which the retroreflective elements are formed has a refractive index with a value in a range of about 1.5 to about 2.5, or a refractive index with a value in a range from about 2.5 to about 3.4.
  • the solution proposed according to the invention makes it possible, in particular, for electromagnetic radiation striking the marker element to be essentially completely reflected back, i.e. retroreflected.
  • the electromagnetic radiation is therefore essentially reflected back in parallel in the direction from which it strikes the marker element and in particular its retroreflective elements.
  • all retroreflective elements especially if they are designed in the form of spheres, have exactly the same diameter. This is particularly irrelevant because each individual retroreflective element reflects the incident light back in the same direction.
  • the size of the retroreflective element is not important.
  • the marker element comprises a carrier for the layer of retroreflective elements.
  • the carrier serves in particular to carry the plurality of retroreflective elements.
  • it also acts in particular as a protective layer for the retroreflective elements.
  • the carrier is preferably formed from a carrier material that is transparent to electromagnetic radiation. It is particularly advantageous if the carrier material does not allow liquids and/or other dirt to adhere as far as possible. This can prevent practically only part of the marker element from being “visible” to the navigation system when dirt covers part of an outer surface of the marker element.
  • the permeability of the carrier material for electromagnetic radiation makes it possible, in particular, for the electromagnetic radiation used to navigate the referencing unit to penetrate the carrier as unhindered as possible, reach the retroreflective elements and be reflected back by them in the direction of incidence or parallel to it.
  • an outer surface of the marker element is formed by the carrier is.
  • the wearer can thus protect the retroreflective elements from contamination, in particular from contamination that could otherwise penetrate into spaces between the retroreflective elements and adhere there.
  • the material from which the retroreflective elements are formed has a refractive index with a value in a range from approximately 1.5 to approximately 2.5 or a refractive index with a value in a range from approximately 2.5 to has about 3.4.
  • a value of the refractive index in the specified ranges is particularly favorable if, as suggested below, the retroreflective elements are provided with a protective layer. In this case, it is advantageous if the refractive index of the retroreflective elements is adapted to the refractive index of the coating in order to achieve the desired retroreflection despite the presence of a protective layer.
  • the marker element can be designed in a particularly simple manner if the retroreflective elements are designed in the form of spheres. Spheres, especially glass spheres, can be produced in large quantities and in a highly reproducible manner. Incident light is reflected back by the spheres parallel to the direction of incidence.
  • the balls In order to be able to design marker elements with small diameters in particular to be retroreflective, it is advantageous if the balls have a diameter in the range of approximately 10 ⁇ m to approximately 50 ⁇ m. It is particularly advantageous if the balls have a diameter of approximately 20 ⁇ m.
  • the retroreflective elements are advantageously made of glass or a plastic. Spheres in particular can be made from both glass and plastic with high quality and precision.
  • the material from which the retroreflective elements are formed has a refractive index with a value of approximately 1.93 or a refractive index with a value of approximately 2.9.
  • Marker elements can be formed particularly cost-effectively and efficiently if the layer is formed in a single layer from the plurality of retroreflective elements. It is particularly advantageous if an outer surface of the marker element is completely provided with a single-layer layer of retroreflective elements. In this way, the entire surface of the marker element can send back as much of the incident electromagnetic radiation as possible in the direction from which it hits the marker element.
  • the plurality of retroreflective elements are each at least partially provided with a coating that reflects electromagnetic radiation. Similar to a mirror, retroreflective elements made of glass, which are provided with the specified coating, for example on the back of the same, can reflect incident electromagnetic radiation back parallel to the direction of incidence. The electromagnetic radiation is then reflected in particular at the boundary layer between the retroreflective element and the coating.
  • the marker element can be produced in a particularly simple manner if the coating is made of a metal.
  • the coating can be produced by vapor deposition.
  • a marker element has particularly good retroreflective properties if the metal is silver or aluminum.
  • Aluminum coatings in particular can be produced easily and cost-effectively.
  • the marker element can be produced particularly easily and cost-effectively if the carrier material is glass or plastic. These materials can in particular be designed to transmit electromagnetic radiation.
  • the use of a carrier material made of plastic has the particular advantage that deformation of the carrier may also be possible after the layer of retroreflective elements has been applied, for example if the plastic is a thermoplastic.
  • the plastic is or contains polymethyl methacrylate (PMMA).
  • PMMA polymethyl methacrylate
  • This plastic also known as acrylic glass, is permeable to electromagnetic radiation.
  • the coating of the PMMA carrier with the retroreflective elements can take place in particular when the plastic has not yet completely hardened, so that the retroreflective elements adhere to its surface or can even be partially embedded in the carrier.
  • the carrier material has a carrier material refractive index which is smaller than the refractive index of the retroreflective elements. This makes it possible, in particular, for electromagnetic radiation striking the marker element to pass through the carrier and impinge on the retroreflective elements.
  • the substrate refractive index has a value in a range of about 1.3 to about 1.7.
  • the carrier material refractive index can have a value of approximately 1.5.
  • the refractive index of PMMA has a value of around 1.49, making this plastic ideal as a carrier material.
  • the layer of retroreflective elements is at least partially embedded in the carrier. In this way, particularly good adhesion of the retroreflective elements to the wearer can be achieved.
  • the production of the marker element is further simplified if the reflective coating is applied to the layer of retroreflective elements that is at least partially embedded in the carrier. This can be achieved in particular by first providing the carrier with the layer of retroreflective elements when producing the marker element and only then is the electromagnetic radiation-reflecting coating applied to the layer of retroreflective elements.
  • marker elements can have any shape. It is particularly advantageous if the layer of retroreflective elements is flat or essentially flat or defines a section of an elliptical surface or a spherical surface.
  • flat, i.e. flat marker elements can be formed, or also spherical or essentially spherical marker elements.
  • spherical marker elements have the advantage that they always show a substantially circular viewing area for the navigation system, practically regardless of orientation in space.
  • the marker element is elliptical or spherical or essentially spherical. As already explained, it plays practically no role for the navigation of the referencing unit how the marker element is oriented in space. The navigation system essentially always sees a circular area.
  • the reflective coating points in the direction or substantially in the direction of a center point of the spherical or substantially spherical marker element.
  • the carrier points away from the center of the marker element and thus forms an outer layer or coating that protects the retroreflective elements.
  • the marker element it can be advantageous if it is designed in two or more parts. In particular, it can consist of two or more marker element parts. For example, a spherical marker element can be produced in a simple manner.
  • the two or more marker element parts are half-shell-shaped or essentially half-shell-shaped. This is how you can do it in particular Assemble spherical marker elements from two half-shell-shaped marker element parts.
  • flat or half-shell-shaped supports can be formed, the inner surfaces of which are coated with the retroreflective marker elements.
  • the marker element parts are then assembled.
  • the retroreflective coating defines an ellipsoidal or spherical or substantially spherical cavity.
  • very light marker elements can be formed.
  • Stability of the marker element can be improved in particular by filling the cavity with a filling material.
  • the marker element can be designed particularly easily and cost-effectively if the filling material is a plastic.
  • the plastic can be a sterilizable plastic.
  • the filling material can already be produced in a form that corresponds to a shape or shape of the cavity, so that, particularly if the marker element comprises several marker element parts, these can be placed over the filling material. However, the filling material can only be filled into the cavity when the marker element parts are joined together.
  • the task set at the beginning is further achieved according to the invention in a referencing unit of the type described above in that the at least one marker element is designed in the form of one of the advantageous marker elements described above.
  • Equipping the referencing unit with marker elements according to the invention enables, in particular, improved visibility of the referencing unit in space and thus a more precise determination of its position and/or orientation in space by the navigation system.
  • the referencing unit For the manageability of the referencing unit, it is advantageous if it comprises a carrier on which the at least one marker element is arranged or formed.
  • a carrier on which the at least one marker element is arranged or formed.
  • conventional carriers can be used here with coupling devices for releasably connecting each to a marker element.
  • the marker elements can then, for example be designed as disposable marker elements; the carrier can be cleaned and used repeatedly after sterilization.
  • the marker elements can also be designed to be processed so that they can be used multiple times. The only requirement is that the materials from which the marker elements are formed are particularly resistant to alkaline cleaning media and can withstand going through at least one hot steam sterilization cycle.
  • the task posed at the outset is achieved according to the invention in a navigation system of the type described at the outset in that the at least one marker element is one of the advantageous marker elements described above and/or in that the referencing unit is designed in the form of one of the advantageous referencing units described above.
  • Equipping a navigation system with such marker elements or referencing units has the advantage that the visibility of both the marker elements and the referencing units is significantly improved by the detection device of the navigation system compared to conventional marker elements with diffusely reflecting surfaces.
  • FIG. 1 A navigation system provided overall with the reference number 10 is shown as an example. It comprises several referencing units 12, which preferably comprise at least three marker elements 14, and four in the exemplary embodiments shown in the figures.
  • the navigation system 10 includes a transmitting and receiving unit 16 for transmitting and receiving electromagnetic radiation and/or ultrasound. It comprises a bar-shaped support 18, on which three transmitters/receivers 20 are arranged, with which electromagnetic radiation or ultrasound can be emitted and/or received. In principle, only two transmitters/receivers 20 could be provided. To ensure accuracy when determining the position of the referencing units 12, three or more such transmitters/receivers 20 can also be provided. Furthermore, the navigation system 10 includes a data processing system 22, which in Figure 1 illustrated embodiment includes three interconnected computers 24, a monitor 26 and an input device in the form of a keyboard 28. The data processing system 22 can be used to process signals generated and/or received by the transmitting and receiving unit 16 in order to determine a position and/or an orientation of a referencing unit 12 in space.
  • Referencing units 12 can in particular be designed in such a way that they can be fixed to a patient 32, for example, with appropriate adapters 30.
  • joint positions and joint centers of the patient 32 can be determined by moving a body part of the patient 32, on which a first reference element 12 is fixed, relative to another body part of the patient 32, on which a further referencing unit 12 is fixed.
  • a referencing unit 12 can also be arranged on a surgical instrument or a tool, for example using an adapter 30 suitable for this purpose.
  • the referencing unit 12 comprises a cross-shaped support 34, which includes four support arms 36 arranged essentially perpendicularly relative to one another, which in particular can have different lengths.
  • Each carrier arm 36 carries a connecting element in the form of a peg-shaped adapter 38, each of which projects vertically from a flat surface 40 of the carrier 34.
  • Each adapter 38 is provided with a circumferential annular groove 42, which forms a locking element.
  • the annular groove 42 is arranged concentrically to a longitudinal axis 44 defined by the adapter 38 and divides the adapter 38 into two parts, which have an length ratio of approximately two to three, with the longer part of the adapter 38 directly adjacent to the carrier 34.
  • FIG. 5 The structure of a first exemplary embodiment of one of the marker elements 14 is shown schematically. It comprises a carrier 92 designed in the form of a spherical shell, which surrounds a hollow core 46.
  • the carrier 92 is provided on an inside facing a center 54 of the spherical shell with a plurality of retroreflective elements 48 in the form of balls 50 made of plastic or glass.
  • An outer surface of the balls 50 is partially provided with a coating 52 that reflects electromagnetic radiation.
  • the coating 52 covers half of the outer surface of each ball 50, such that the outer surfaces of the balls 50 are provided with the coating 52 essentially only on their surface areas adjacent to the hollow core.
  • the balls 50 with the coating 52 are therefore arranged in such a way that the coated, hemispherical surfaces point towards a center 54 of the core 46.
  • the retroreflective elements 48 can be applied directly to the inside or to the inner surface of the carrier 92 with an adhesive or adhesive. Optionally, they can also be partially embedded in the carrier 92.
  • FIG 6 A beam path of electromagnetic radiation 56 striking the marker element 14 is shown schematically. Here, a transition from an optically thinner to an optically denser medium takes place when the radiation hits the carrier 92. If the radiation 56 does not hit the carrier 92 perpendicularly, then it is already refracted towards the plumb line when air passes into the carrier 92.
  • the refractive index of the balls 50 is preferably chosen to be greater than a refractive index of the carrier material from which the carrier 92 is made.
  • the carrier 92 is formed from polymethyl methacrylate (PMMA) whose refractive index is approximately 1.49, it is advantageous if a refractive index of the balls 50 is approximately 2.9. This can be achieved by appropriately selecting a plastic or glass to form the balls 50.
  • This choice of refractive indices results in a further transition from an optically thinner medium, namely the carrier 92, into an optically denser medium, namely the balls 50. Again, the radiation 56 is refracted towards the plumb line.
  • Each ball 50 can be designed in multiple layers or consist of a mixture of materials. These configurations enable, in particular, an individual adjustment of the refractive index of the balls 50.
  • the radiation 56 is reflected at the boundary layer between the sphere 50 and the coating 52. Furthermore, the radiation 56 changes its direction again when it emerges from the ball 50 into the carrier 92 and when it emerges from the carrier 92 into the surrounding air, so that it is parallel to a direction of incidence 58 to which it also hits the ball 50 parallel , is sent back to the transmitter/receiver 20 of the navigation system 10.
  • the beam path is off Figure 6 shown again in detail on a ball 50.
  • the radiation 56 striking the carrier 92 perpendicularly strikes the ball 50 at an angle of incidence 60 relative to a tangential plane 62 of the ball 50 and is refracted towards the surface normal 64 perpendicular to the tangential plane 62.
  • An angle of reflection 66 in the optically denser medium is smaller than the angle of incidence 60.
  • the radiation 56 is totally reflected at a boundary layer between the sphere 50 and the coating 52.
  • an angle of incidence 68 corresponds to the angle of reflection 70, with the reflection taking place relative to a tangential plane 72 at the boundary layer between ball 50 and coating 52.
  • the radiation 56 again impinges on an interface between the sphere 50 and the carrier at an angle of reflection 74 which corresponds to the angle of reflection 66.
  • the radiation 56 passes below an angle of incidence 80 from the sphere 50, the angle of incidence 80 corresponding to the angle of incidence 60.
  • a direction of incidence 82 of the radiation 56 thus runs parallel to an emission direction 84 of the totally reflected radiation 56.
  • FIG 7 a second exemplary embodiment of a marker element, designated overall by reference number 14 ', is shown schematically. Similar to the in Figure 5 Marker element 14 shown, the size relationships between the retroreflective elements 48 and 48 'do not match the dimensions of the marker elements 14 and 14'.
  • the marker elements 14 and 14' can, for example, have a diameter of approximately 10 mm, the retroreflective elements 48 and 48' can have a diameter of approximately 20 ⁇ m. This results in that a layer 86 or 86' of the retroreflective elements 48 or 48' comprises significantly more balls 50 or 50' than is shown in the figures.
  • the marker element 14' is designed in two parts and comprises a first marker element part 88' and a second marker element part 90', each of which is essentially half-shelled.
  • Each marker element part 88' includes an electromagnetic radiation-transmissive support 92' having an outer surface 94' facing away from a center 54' of the marker element 14'. The surface 94' is thus convexly curved pointing away from the marker element 14'.
  • the balls 50' are partially embedded in the carrier 92'. At the in Figure 7 illustrated embodiment of the marker element 14 'about half.
  • the layer 86' of the retroreflective elements 48' is formed in a single layer and points towards the center point 54' with its sides pointing away from the carrier 92'. Furthermore, the balls 50' are again provided with a coating 52' that reflects electromagnetic radiation. This forms an inner surface of the hemisphere-defining marker element parts 88' and 90'. The marker element parts 88' and 90' are cohesively connected to one another with an adhesive layer 96'.
  • a spherical cavity 98' delimited by the coating 52' can be filled with a filling material.
  • This preferably forms the shape of a ball 100 'with a coupling recess 102', which is preferably designed to correspond to the adapter 38.
  • projecting locking elements 104' can be provided on the coupling recess 102', which engage in the annular groove 42 when the marker element 14' is coupled to the adapter 38.
  • the ball 100' is preferably made of a sterilizable plastic.
  • the marker element parts 88' and 90' can be connected to the ball 100' in a materially bonded manner, for example by means of an adhesive layer.
  • FIG 8 A beam path of electromagnetic radiation 56 striking the marker element 14' is shown schematically. Here, a transition from an optically thinner to an optically denser medium already takes place when the radiation hits the carrier 92'.
  • the refractive index of the spheres 50' is preferably selected to be greater than a refractive index of the substrate material from which the substrate 92' is made.
  • the carrier 92' is formed from polymethyl methacrylate (PMMA), the refractive index of which is approximately 1.49, it is advantageous if a refractive index of the balls 50' is approximately 2.9. This can be achieved by appropriately selecting a plastic or glass to form the balls 50'.
  • Each ball 50' like each ball 50, can be designed in multiple layers or consist of a mixture of materials. These configurations enable, in particular, an individual adjustment of the refractive index of the balls 50 and 50'.
  • the electromagnetic radiation 56 is refracted when entering the carrier 92 'towards the surface normal 106' of an outer surface of the carrier 92'.
  • An angle of incidence 108' is greater than an angle of reflection 110' in the optically denser carrier 92'.
  • the beam path of the electromagnetic radiation 56 when passing from the carrier 92 'into the sphere 50' essentially corresponds to the course as in Figure 3 shown, because the carrier 92 'is made of an optically thinner material than the balls 50' so that in connection with Figure 3
  • the carrier 92 ' enables a retroreflection that is as trouble-free as possible, because contamination of an outer surface of the carrier 92', for example by grease or water, then only leads to a parallel offset and not to a massive disruption in the visibility of the marker element 14', as is the case with conventional ones Marker elements is the case.
  • the marker element parts 88 and 90' can be produced by first providing a flat support 92' with the layer 86' of the retroreflective elements 48'.
  • a plate made of acrylic glass, for example provided with embedded balls 50 ', can then be formed in a next step into half a hollow sphere, as shown in section Figure 7 is shown as an example as a marker element part 88 'or 90'.
  • an intensity distribution of the radiation retroreflected by a marker element 14 or 14 ' is shown schematically, as shown it results from an image of the marker element 14 or 14 'recorded with the transmitting and receiving unit 16 of the navigation system 10. Since only part of the radiation 56 can be retroreflected by the retroreflective elements 48 or 48 'when radiation 56 is incident on the marker element 14 or 14', taking into account the refractive indices of the balls 50 or 50' and the carrier 92 or 92', it follows in the outer area of the image of the marker elements 14 or 14 ', a significantly weakened intensity signal.
  • the non-reflected portions 114 of the radiation 56 are symbolized, for example, as dotted bars above the schematically illustrated marker element.
  • an intensity or gray value distribution is obtained with a maximum, which indicates a center point of the marker element 14 or 14' in the case of an uncontaminated marker element 14 or 14'. This is because when the marker elements 14 or 14' are formed in the manner described, only part of the sphere 50 or 50' can actually send back the incident radiation.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Robotics (AREA)
  • Geophysics And Detection Of Objects (AREA)
  • Optical Elements Other Than Lenses (AREA)
  • Investigating Or Analysing Materials By Optical Means (AREA)
  • Illuminated Signs And Luminous Advertising (AREA)
  • Radar Systems Or Details Thereof (AREA)
EP16781364.1A 2015-10-09 2016-10-10 Chirurgisches markerelement, chirurgische referenzierungseinheit und chirurgisches navigationssystem Active EP3359077B1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102015117239.9A DE102015117239A1 (de) 2015-10-09 2015-10-09 Chirurgisches Markerelement, chirurgische Referenzierungseinheit und chirurgisches Navigationssystem
PCT/EP2016/074186 WO2017060522A1 (de) 2015-10-09 2016-10-10 Chirurgisches markerelement, chirurgische referenzierungseinheit und chirurgisches navigationssystem

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EP3359077A1 EP3359077A1 (de) 2018-08-15
EP3359077B1 true EP3359077B1 (de) 2023-12-06

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US (1) US20180221108A1 (ja)
EP (1) EP3359077B1 (ja)
JP (1) JP6855468B2 (ja)
CN (1) CN108348302A (ja)
DE (1) DE102015117239A1 (ja)
WO (1) WO2017060522A1 (ja)

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US10779893B2 (en) * 2018-10-18 2020-09-22 Warsaw Orthopedic, Inc. Spinal implant system and method
CN109953828B (zh) * 2019-05-07 2020-06-23 北京和华瑞博医疗科技有限公司 一种参考架坐标系找回方法以及参考架坐标系找回装置
EP3738542A1 (en) * 2019-05-15 2020-11-18 Stryker European Holdings I, LLC Tracker for a surgical navigation system
CN113208728A (zh) * 2021-04-01 2021-08-06 杭州键嘉机器人有限公司 一种连接装置

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JP2018533397A (ja) 2018-11-15
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WO2017060522A1 (de) 2017-04-13
US20180221108A1 (en) 2018-08-09
EP3359077A1 (de) 2018-08-15
CN108348302A (zh) 2018-07-31

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